Inspection on 15/01/07 for Oakcroft Nursing Home

This inspection was carried out on 15th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oakcroft Nursing Home 07/01/09

Oakcroft Nursing Home 27/03/08

Oakcroft Nursing Home 15/05/07

Oakcroft Nursing Home 19/05/06

Oakcroft Nursing Home 03/03/06

Oakcroft Nursing Home 05/09/05

Oakcroft Nursing Home 31/03/05

Oakcroft Nursing Home 09/11/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Oakcroft Nursing Home Oakcroft 41-43 Culverley Road Catford London SE6 2LD Lead Inspector Unannounced Inspection 15th January 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oakcroft Nursing Home Address Oakcroft 41-43 Culverley Road Catford London SE6 2LD 020 8461 5442 020 8698 0636 oakcroftnursing@btinternet.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Moore Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 28 patients, frail elderly persons aged 60 years and above (female) and 65 years and above (male) 19 May 2006 Date of last inspection Brief Description of the Service: Oakcroft Nursing Home provides care for up to 28 older people, up to three of whom may have a physical disability. It caters for respite care as well as longterm care. The home is a detached house with three storeys close to Catford train station and local shops and services. The area is also well serviced by buses to central and south London. There is accessible off road car parking space for up to 6 cars to the front of the building. There is a garden and patio to the rear accessible from the dining room. On the day of inspection there was one vacancy. The weekly fees are £618.86 per week Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the day of 15th January. When the inspector arrived an RGN was in charge but the acting manager came soon after and facilitated the inspection. The proprietor was also present for some of the time. The inspector spoke to service users, staff and one relative who was visiting the home. She made a tour of the premises and checked care plans and other documentation. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5,6. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users do not have a full, up-to-date assessment of their needs and do not visit the home. They therefore cannot be sure that their needs will be met. EVIDENCE: A service user was admitted for respite over the Xmas period. The Community Care information on file came from 16 months before, and described complex physical needs, as well as severe dementia and also challenging behaviour. However, there was no evidence of a pre-admission assessment to determine whether the home could meet the service user’s needs. Another service user was admitted on a permanent basis with no evidence of a pre-admission assessment. There is no evidence of any efforts made to enable service users to visit the home before admission. The home does not offer intermediate care. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 8 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot be sure that their care needs will be assessed and documented or that all their health needs will be met. They are also not protected by risk assessments where needed. Some areas of dealing with medication do not properly protect service users. Service users’ privacy and dignity must always be upheld. EVIDENCE: A service user who was admitted for respite over the Xmas period did not have a care plan covering all her physical or mental needs. A service user admitted for permanent care in November did not have a care plan which covered all her complex needs. There was no evidence that relatives are consulted about care plans or reviews even when they visit frequently. At the moment the home is using several different care plan formats but none of the files seen had care plans covering all the physical, emotional and social needs of the service users; very few had life histories. Although a start had Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 9 been made, most did not assess arrangements for dealing with service users’ finances to ensure they had access to their money. Of the care plans seen, two were for people with a history of falls and whose risk of falling was assessed as high. However this did not lead to risk assessments where the risk of falls was analysed and then strategies planned to minimise the risk. Similarly, care plans were seen where violence and challenging behaviour was documented but no assessment made of the risk or advice to staff on how to minimise and deal with the behaviour. Bedsides are still being widely used with no risk assessment. Service users are also being transported in wheelchairs without an assessment. One lady had been seen in November by a physiotherapist who assessed her as needing a zimmer frame to move around with. However her care plan which had been written earlier in the month had not been changed to reflect this and on the day of inspection she was being moved in a wheelchair. The wheelchair did not have footplates on, which is a health and safety hazard. Health care was not always being properly documented, monitored or acted upon. A service user who had had a pressure sore did not have her treatment documented. It is noted however that the pressure area healed and the new acting manager has now introduced new documentation. A service user had lost over a stone in a year but no action had yet been taken to seek advice on this. A service user with epilepsy did not have a record of when fits occurred. Medication was checked. The administration chart looked properly filled in but it was not possible to check this as amounts of stock held were not recorded anywhere and so it is not possible to check administration. The home has not yet ensured that all areas are properly covered in its medication policy. There was also no evidence that service users’ medication needs had been reviewed in line with the pharmacy inspector’s requirements at the last inspection. The pharmacy inspector had also required that medication was given at the right time and this is not yet being carried out as medication due in the morning at 9 am was still being administered at 11 am with more due at 1pm. Service users spoken to, as well as a relative, felt that they were treated well. However while the inspector was there medical treatment was given, by a nurse, in the lounge with other people present. This is not a practise which respects the privacy or dignity of service users. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot yet take part in meaningful activities and their wishes are not assessed and no activity is provided. Service users can keep contact with family and friends as they wish. They do not have a proper choice of food, and the nutritional content of their diet is doubtful. EVIDENCE: There is still no activities programme in the home to help service users pass the time, and to give them stimulation. During the day the inspector saw no sign of any organised activities or one to one impromptu activities going on. Carers were seen to be sitting separately, not interacting with service users. Two televisions were on throughout the day, but with no sound, whilst loud music was being played. Although materials to be used in activities have been bought these are not being used and carers have not attended training on helping service users take part in activities. Service users’ wishes and abilities for social activities have not yet been fully assessed. Visitors continue to be made welcome in the home at any time. Service users can bring in personal possessions for their rooms. However systems are not Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 11 yet in place to enable service users to have access to their money on a day-today basis. When asked, service users said that they enjoyed their food. However there are issues which are of concern in terms of meal provision and nutrition. Breakfast on the day of inspection was marmalade sandwiches, which is not something usually offered to, or eaten by adults. This was served together with cereal or porridge and small dishes of fruit cocktail for some. Although there were fresh vegetables at lunch the chicken pie was frozen and desert was bought cake and custard. Supper is sandwiches, packet soup or fish fingers. There was no fresh fruit in the home other than some old bananas. Most food is therefore ready prepared and very much starch based. There is no choice of food at the main, midday meal. Also breakfast did not start to be served until 10 and some people were still eating it at just before 11. Lunch is served at 1.30 and supper at 5.30. This leaves a very long gap between supper and breakfast and although sandwiches or biscuits are available during the night, most people do not eat them. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. It is not possible to be sure whether complaints are acted upon as they are not always recorded. Service users still need the protection of policy and procedures about what action will be taken by staff in the event of possible abuse. EVIDENCE: There is a complaints policy which service users and their families have, in the past, been informed about. The commission has received no complaints about the home. No complaints are recorded in the home’s complaints book. However a relative said that she had complained about clothes of her mothers which had been lost. This should have been recorded, together with the outcome of an investigation. The home’s vulnerable adult’s policy has not yet been revised to give full guidance to staff as to what to do in the event of an allegation of abuse by a service user. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Oakcroft is homely. However it does not meet the service users’ need for communal space, or at the moment, for bathing facilities. The home is clean and hygienic. EVIDENCE: A start has been made on improving the environment at Oakcroft. Some rooms have been decorated. Those that have not, are in quite a poor state of decoration, but the maintenance man spoke of his intention to draw up a programme to ensure that all the rooms are brought up to scratch. Some of the rooms have been well personalised although some are bare. Not all had two comfortable chairs in. Double rooms are being converted into singles with only two now remaining as doubles. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 14 However the communal space continues to be inadequate. As before all service users sit all day in the one lounge. Two televisions were on with no sound, and music was playing from a sound system. At the moment there is only one shower in use as carers are not using the hydro bath. This arrangement is not suitable for 21 service users, who should be consulted as to whether they are happy to use the bath. If they are not a second shower should be installed. The fire exit to the left of the ground floor was seen to be a hazard to use. On the day of inspection the home was clean and hygienic throughout. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30. Quality in this outcome area is (excellent, good, adequate or poor). This judgement has been made using available evidence including a visit to this service. Service users are supported by staff deployed in adequate numbers. However lack of a training programme means that they cannot always be sure they are competent in all necessary areas. EVIDENCE: The home continues to deploy adequate staff to care for service users. However they have been using an RGN for up to 59 hours per week to cover shortages and this is not recommended. Staff who do not know the home or have only been working there for two to three weeks have also been left in charge, which again is not good practise. No new care staff have been taken on since the last inspection, when recruitment checks were found to be appropriate. There has been very little recent training and there is no training programme. What training there is, is not based on the assessed needs of staff or service users. Staff have also, still not had training on how to deal with the leisure needs of service users and this is apparent in the lack of activity in the home. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Due to disruptions to management arrangements, service users cannot be sure that the home is run by a competent person. Quality assurance systems and an annual development plan still need to be set up. Service users’ financial interests need to be addressed. Staff need to be supported by regular supervision and appraisal. There were some health and safety issues in the home. EVIDENCE: The registered manager left since the last inspection, a temporary manager was taken on and a second temporary manager has now taken over. The home still does not have an annual development plan. Quality assurance is not taking place and the monthly monitoring visits by the person in charge Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 17 have not been happening either. Supervision and appraisal for staff has not yet been put in place. During the tour of the home several health and safety issues were noticed. There were two instances where unlabelled chemicals were seen around the home; fire door was wedged open; an oxygen cylinder was stored in a corridor and paint was stored in a sluice room. Both of the last two items are fire hazards. Systems were seen for fire safety and monitoring water temperature and it is recommended that these checks should be made more often. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 2 2 X X X X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 1 1 X 2 Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Timescale for action 14(2)(a,b) The registered person must 31/03/07 ensure that all service users’ pre-admission assessments cover all aspects of care needs in the detail needed for the home to confirm that it can meet those needs. Target date of 31/07/06 not met. 14(1)(c) The registered person must 31/03/07 ensure that every effort is made to enable prospective service users to visit the home before admission. The registered person must 31/03/07 ensure that all care plans are completed immediately on admission. Target date of 22/05/06 not met. The registered person must 31/03/07 ensure that any risk areas for service users should be fully assessed and documented. Target dates of 31/03/05, 31/10/05 and 31/07/06 not met. Regulation Requirement 2. OP5 3. OP7 15(1) 4. OP7 13(4)(b,c) Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 20 5. OP7 13(1)(b) 4(b,c) 6. OP7 14(1)(a) 15(1) 7. OP7 OP12 15(1) 15(2) (b,c,d) 16(2)(m) 8. OP7 15(1) 9. OP7 15(1) 10. OP9 13(2) The registered person must ensure that no service user is transported in a wheel chair unless the need for this has been assessed by an appropriate professional, the wheelchair has been assessed as suitable and the wheelchair is satisfactorily maintained. Target date of 30/07/06 not met. The registered person must ensure that the care needs of service users suffering from dementia are fully assessed. Target date of 31/07/06 not met The registered person must ensure that all service users’ social and leisure needs’ assessments are completed in consultation with service users or their representatives and kept under review Target dates of 31/01/06 and 30/06/06 not met. The registered person must ensure that all service users or their representatives are consulted about the review of their care plans and sign their plan to reflect agreement. Target date of 31/07/06 not met. The registered manager must ensure that individual service users abilities to manage their own personal finances are taken into account in the care planning process. Target dates of 31/01/06, 31/05/06 and 31/08/06 not met. The registered person must ensure that the home has a policy for self-medication and that the policy for destruction of medication is updated. DS0000007037.V326745.R01.S.doc 31/03/07 31/03/07 31/03/07 31/03/07 31/03/07 31/03/07 Oakcroft Nursing Home Version 5.2 Page 21 11. OP9 12. OP9 13. OP9 14. 15 OP10 OP12 16. OP15 17 OP15 18. OP16 Target date of 31/07/06 not met. 14(2)(a,b) The registered person must ensure that service users’ medication is reviewed, especially in relation to daytime and nighttime sedation. Target date of 31/07/06 not met. 13(2) The registered person must ensure that medication is given at the prescribed time. Target date of 31/07/06 not met. 13(2) The registered person must ensure that stocks of medication are recorded so that administration can be checked. 12(4)(a) The registered person must ensure that all nursing care is given in private. 16(2)(m) The registered person must (n) ensure that a programme of activities is developed based on service users’ assessments as required above. Target date of 31/10/06 not met. 16(2)(i) The registered person must ensure that there is a choice on the menu for the main meal and service users’ choices are recorded and acted upon. Target date of 31/07/06 not met. 16(2)(i) The registered person must ensure that advice is taken from a dietician to ensure that the home’s menu is nutritious and balanced. Target date of 30/08/06 not met. 22 The registered person must ensure that all complaints and their investigation are recorded in the home’s complaint book. Target date of 31/07/06 not met. DS0000007037.V326745.R01.S.doc 31/03/07 31/03/07 31/03/07 31/03/07 30/04/07 28/02/07 30/04/07 31/03/07 Oakcroft Nursing Home Version 5.2 Page 22 19. OP18 13(6) 20. OP19 23(2)(b) 21. 22. OP19 OP20 23(4)(b) 23(2)(e) (h)(i)(j) 23 OP21 23(2)(j) 24. OP30 (18)(1) (a,b,c) 25. OP33 24.1 (a,b) 26. OP35 12 (2,3)23(2 The registered person must ensure that the adult protection procedure is revised to develop more fully what action must be taken in the event of an allegation being made. Previous timescales of 01/05/04, 31/01/05, 30/06/05, 30/04/06 and 30/06/06 not met. The registered person must ensure that the intention to decorate all bedrooms is carried out. The registered person must ensure that the ground floor fire exit is made safe to use The registered person must ensure that adequate communal sitting, recreational and dining space is provided. Target date of 31/07/06 not met. The registered person must ensure that there are sufficient bathing and shower facilities in use. The registered person must ensure that the manager puts into place a staff training and development plan to ensure the needs of the service users can be properly met. Target dates of 31/03/05, 31/07/05, 30/11/05, 31/05/06 and 31/07/06 not met. The registered person must ensure that an annual development plan and a quality assurance system for measuring satisfaction with the service are put into place. Target dates of 30/04/05, 31/12/05, 31/05/06 and 31/12/06 not met. The registered person must ensure that the home’s policy for DS0000007037.V326745.R01.S.doc 28/02/07 31/07/07 31/03/07 30/06/07 31/07/07 31/03/07 30/06/07 31/03/07 Page 23 Oakcroft Nursing Home Version 5.2 m) 27. OP36 (18)(2) 28. OP38 13(4) (a,b,c) service users’ finances are reviewed to take into account the need for service users to manage their own finances if they so wish and are so able. This will entail ensuring there are procedures for properly dealing with personal allowances if the service user wishes this to be held for them by the home. Target dates of 31/07/05, 30/11/05, 31/05/06 and 30/11/06 not met. The registered person must 31/03/07 ensure that all care staff receive supervision and appraisal in accordance with the requirements of this standard. Target dates of 31/07/05, 31/10/05, 30/04/06 and 31/07/06 not met. The registered person must 31/01/07 ensure that the health and safety issues highlighted in this section are RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP15 OP27 OP27 OP31 Good Practice Recommendations It is recommended that service users’ food and drink intake between supper and breakfast is monitored. It is recommended that staff should not work excessive hours in one week. It is recommended that staff left in charge of the home should have worked there for long enough to know the service users, policies and procedures. The registered person must ensure that the registered person should consider providing additional temporary or permanent management support, to enable the DS0000007037.V326745.R01.S.doc Version 5.2 Page 24 Oakcroft Nursing Home development of the service, as outlined in the requirements of this report. 5. 6. OP33 OP38 It is recommended that the person in charge makes monthly monitoring visits, which are recorded. It is recommended that all water temperatures and fire systems are checked at least monthly. Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SE London Area Office River House 1 Maidstone Road Sidcup DA14 5RH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oakcroft Nursing Home DS0000007037.V326745.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!